Permit Roof 321 3rd St 2012 r tP
CITY OF ATLANTIC BEACH
j s) 800 SEMINOLE ROAD
5 V ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000453 Date 4/18/12
Property Address 321 3RD ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 5000
Application desc
ROOF
Owner Contractor
DYAL NELIGAN CONSTRUCTION (ROOFING)
321 3RD STREET PO BOX 49249
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 247 -3777
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 5000
Expiration Date . 10/15/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 79.00 79.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 3 a , c` 1 ?) Permit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 5 boo .vu Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial Resi entiall
dap
If an existing structure, is a fire sprinkler system installed? (Circle one): Ye s N
Florida Product Approval # . r '. ' to 5
For multiple products use pro • uct approva orm 4
Describe in detail the type of work to be performed: d m ; O.? f E.Kis ock 1 - ObV"
Property Owner Information:
Name: ` a k • .. 3a1 ■ h - A 5\--f -
Ad dress: � r
Cit Gvna h : Sg State 'i Zip £ 33 Phone ig i \O ‘7
E -Mail or Fax # (Optional)
Contractor Information: ,,��
Company Name: • -: , u • %A „sa k 4 n. r .� ... - L-- ' ualifying Agent: f �c1tc(\ \,' �� •,,
Address: QC , r - 1 c\ �
, - • City X� o i State , I Zip o W
Office Phone aao - to Job S'te/ Contact Number i A, like - Fax # r,7 . 2 - l •Z t
State Certification /Registration3�ot�j r j
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certifi, that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void f work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a_ period of six _(6) months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo Heaters,
Tanks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereby cert y that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein . ot. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other Feder. state, or local law regulating cons • , ction or th . erformance of construction.
Signature of Owner ,
Si
gn el fir.` Si gnature of Contractor /24_
Print Name / 4-4/4- V ...,_ , ,
Print Name c . .
Sworn 19 and subscribed before me Sworn to and subscribed before me
this 3 D._v of A • - a , 20 \ Z_ this 5 Day o A 0 . ° 20
i.. ra,vN # D0973752 zmECTH ANNE LAMpKIE II
b.
S March 22, 2014 0 ru.is_
e MY COMMISSION # DDSi7' ed 01.26.10
se�e.0 : z 'rraF rca,y$pvice.00m • ' 'fi • EXPIRES March 22, 2014
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Doc # 2012084223, OR BK 15915 Page 2272,
NOTICE OF COMMENCEMENT Number Pages: 1
Recorded 04/18/2012 at 10:24 AM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
Permit No. RECORDING $10.00
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property (legal description):
a) Street (job) Address: a ',�` _ mi x .
2.General description of improvements: li atEnrarg6s ,y ��; S
3.Owner Information .� `
a) Name and address: Dt0.'(1P. �Yt,I . 5 - 2A — �
C
� lr�ira r ■c &gcV-■Tj. 3a0.-33
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property
4.Contractor Information `,`r
g a) Name and address: ����1 c •6 . l tl t . a � U t . �• 3Zt `C =
b) Telephone No.: ' • ! a(Q • Fax No. ( pt.) QS* 5/ 2 - 1 Z 1
.Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6.Lender
a) Name and address:
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date
is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE a
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.1
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER `
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST a R
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFO ' N
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMME EMENT. to
z g
STATE OF FLORIDA )7 ` / = y
COUNTY OF [„►s 1Dumal 10. �. 0 it
cr y
Signature of Owner of er Authorized O cer/Di>�ectOr ' . er anager 0 a,
.IL / J 1 ijJl i— .. L N v W .
Print Name i tL 1 -
4 ; 4
The foregoing instrument was acknowledged before me this S day of A 'Q C ` 1 , 20 \ 2-, by
•
as (type of authority, e.g. officer, trustee, "
attorney in fact) for (name of party on behalf of whom in trument wa xecuted .
Personally Known OR Produced Identification Notary Signature t _ % I 11 )1S) • t ,
Type of Identification Produced Name (print) � k l ' , nE, 411 t ` Z. ,1
OR
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
FORMS/NOC,rvsd2010
Signature of Natural Person Signing (in line # 10.) Above